Things you should know about pacemakers

The pacemaker sends an electrical impulse to heart muscles.

It induces artificial heartbeat in patients whom the heart rate is very slow.

A pacemaker also is able to sense the normal heartbeats.

The pacemaker is a tiny device weighing 25 to 35 grams, used for sending an electrical impulse to heart muscles to induce artificial heartbeat in patients whom the heart rate is very slow. The normal heart rate is 60 to 100 per minute. At very slow heart rate, especially when it is lower than 40 per minute, a person may become symptomatic of giddiness, black out episodes or may also have episodes of brief loss of consciousness. If such symptoms arise, it becomes essential to implant a pacemaker said Dr. Santosh Kumar Dora, Senior cardiologist from Asian Heart Institute.

In addition to the capability of stimulating the heart muscle, a pacemaker also is able to sense the normal heartbeats. If it senses the normal beat, then it does not stimulate the heart unnecessarily. In other words, this is known as demand pacing. It saves battery and increases the durability of the pacemaker.

The pacemaker is implanted below the left or right collarbone underneath the skin and fat tissue. The leads are passed via vein and connected to the heart muscle in one end and connected to the pacemaker in the other end. The pacemaker parameters are programmable and can be changed externally by a programmer. Normally a pacemaker lasts for 10 to 12 years depending on the current it utilises to stimulate the heart said Dr. Dora from Asian Heart Institute.

Patients having pacemaker have mostly no restriction in their normal activities. However, there are few things the patient should know.

Use a cell phone in the opposite ear i.e. if pacemaker is implanted below left collarbone, then cell phone should be used on the right side.

Do not go near to the high tension wires. The patient can use household electric appliances without any problem. The household electrical appliances should be well grounded. There is no problem in switch off/on, watching the TV, operating the computer, operating the microwave oven etc.

Pacemaker patients should pass through the metal detectors fast and should inform the security personnel about the device. So the security personnel will check the person by hand rather than using the hand-held metal detector.

Pacemaker patients should not remain very close to the metal detectors or theft detectors placed in the malls or other areas.

Many medical investigations like ultrasound, echocardiogram, X-ray, CT scan can be safely performed in these patients without any fear. However magnetic resonance imaging ( MRI) should not be done in these patients, as it can damage the pacemaker circuit. Recently the MRI compatible pacemaker is also available and if the patient has this kind of pacemaker, then MRI can be done safely.

Radiation therapy which is needed in some cancer patients can damage the pacemaker if the pacemaker comes directly in the radiation area. So measures are taken to avoid direct exposure of the pacemaker to the radiation beams.

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